Join the WEDI Dental Workgroup leaders for an informative webinar looking at readiness challenges, best practices and case studies as the industry adjusts to ICD-10. The webinar is complimentary and is appropriate for dental providers and payers as well as billers, coders, and other interested dental industry stakeholders.

The home health industry’s reimbursement cycle is unique in the health care continuum. In-patient settings will use the date of discharge as their transition compliance date. Other healthcare entities will use the date of service as their ICD-10 conversion date. Homecare, on the other hand, is reimbursed per a 60 day episode, corresponding to multiple dates, not one. This means, the transition to ICD-10-CM for home health, is August 3, 2014, not October 1st. Claims will require mandatory dual coding beginning nine weeks prior to the October transition date with ICD-9 codes used for a portion of the bill and ICD-10 codes listed on the final claim. The home health industry is faced with unique challenges leading up to the ICD-10 transition. The compliance date arrives earlier for homecare than any other healthcare entity and the compensation process will require an in-depth understanding by home health coding and billing specialists. Industry problem solving and reimbursement solutions will be discussed and analyzed in this presentation.

Join the EDI data doctors at PLEXIS Healthcare Systems to get a new prescription for maximizing the performance of your electronic data lifecycle. Learn how we can help you streamline your EDI operations and reduce your administrative and processing costs.

ACA, MACRA and recent policy has fast-tracked the shift of healthcare payment from volume- to value-based reimbursement. This session will explore the waters of payment transformation through the use of data and essential strategies and technologies associated with population-based payment archetypes associated with alternative payment models (APMs) and the merit-based incentive payment system (MIPS) set forth under MACRA.

Improve the data structure of information sent from the exchanges to health insurance plans and the way in which the data is transmitted with standardized data formatting and transport. Current processes are difficult to automate and scale. A complete and standardized method is needed for packaging and sending enrollment data from the exchanges to carriers, simplifying and expediting the plan purchasing process.

In preparation for ICD-10 implementation in 2014, stakeholders on all sides of the coding scenario need to be fully prepared. Companies must conduct end-to-end testing, and it is imperative that the testing is thorough. Your end-to-end testing will replicate your organization’s systems to assess operational readiness and will flag potential hiccups or unexpected outcomes prior to implementation. An end-to-end testing scenario that is lacking could leave you unprepared. This webinar specifically addresses payers.

The Privacy and Security Workgroup has always tried to stay on the leading edge of providing the industry with appropriate information related to regulatory changes and to help implementation concerns. You are invited to join us for a webinar to talk about what you see as critical issues within the Security & Privacy landscape and discuss how WEDI can best address them. We are actively recruiting volunteers that may have an interest in participating on our Privacy and Security sub-workgroups.

BlueCross BlueShield of Arizona’s ICD-10 Project Co-Sponsor will share the details of their process for developing the project’s Risk Mitigation Plan. Details include identification and ranking of risk, pre- and post-implementation strategies and action plans, including command center. The webinar will focus on the process for developing a plan rather than the content of the plan specific to this payer.

The 90-minute WEDI/OCR virtual sessions will explore compliance with various aspects of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules, as well as the HITECH Breach Notification Rule.

The recent change in the ICD-10 compliance date has caused the industry to revisit implementation plans. WEDI held an emergency ICD-10 Summit on April 30 to discuss impacts of the delay and to build a suggested roadmap toward compliance. This webinar will discuss causes and consequences of the delay and will describe actions contained in the roadmap.

The WEDI Innovative Encounters Workgroup evaluates business cases and return on investment (ROI) for innovative encounter models (e.g., electronic visits and communication, electronic monitoring, telemedicine) using existing and emergent technologies that will foster enhanced collaboration between patients and providers at a lower cost and with increased value, and compare characteristics to in-person patient encounters.

It is widely anticipated that the implementation of ICD-10 will increase the percentage of claims suspended (pending addition information) and claims rejected. This has several undesirable effects:
• increased capital allocation in anticipation of claim resolution
• financial risk to the provider community
• increased staffing for both payer and provider
While there is no easy fix for claim adjudication – thanks to the efforts of HHS’s Office of the National Coordinator there is now an easy, low cost way to connect to the entire provider community. This talk will share how the payers can leverage the existing standards to reduce their exposure.

ICD-10 presents one of the greatest changes to health information in decades. For any change of this magnitude the risks of problems and ultimately failure are significant. To mitigate the impact of these predictable challenges, it is critical to have a well thought-out contingency plan in place. This presentation will discuss the key aspects of contingency planning.
• Making the contingency plan part of the project plan
• Identifying risks
• Defining options
• Picking the right options for the right problem
• Options triggers and execution
• Understanding the impact of options
• Recovering from options
• Monitoring the result of implementation
Contingency planning cannot be an afterthought. As much as we want to believe in success, being ill prepared to address problems and develop alternatives can result in catastrophic failure.

This webinar is to provide the participants an overview of contingency plans with the related benefits and industry consequences for several potential ICD-10 events that will impact business continuity. The webinar will provide a foundation to begin individual and industry-level contingency plan discussions in preparation for the October 1, 2014 implementation.

The HIPAA regulations passed in 1996 made provisions for a Unique Patient Identifier. What is the future of a Unique Patient Identifier? What are the barriers to implementation? With the advancements in technology and changes in the health care industry, is there still a need for a Unique Patient Identifier? This webinar will review the current barriers and potential value propositions of a Unique Patient Identifier under the existing health care reform regulations.

This town hall discussion will be touching on a variety of topics including the future of the federally-facilitated and state-based marketplaces, the 2015 changes to Qualified Health Plan certification requirements, shared services models, and transition challenges for the upcoming year. We are hoping for a lively and interactive session.

Applying the plain language of the HIPAA/HITECH regulations might help your organization achieve minimal legal compliance, but it may not adequately protect your organization against legal and business risk. This presentation explores lessons learned from more than a decade of negotiating business associate agreements and from handling dozens of security incidents. More specifically, the presentation will address the provisions of business associate agreements that really matter and how to get the contract language that best protects your organization, whether your organization is a covered entity negotiating with a business associate or a business associate negotiating with a subcontractor. This presentation also will address some of the toughest issues surrounding security incident response, such as whether a compromise has occurred and how to use law enforcement involvement to your organization’s advantage. The presentation will conclude with a review of recent HHS enforcement activity and its practical implications for both covered entities and business associates.

Protecting your healthcare organization’s data is no longer just about managing the systems inside your business. The final Omnibus Rule states that covered entities must get satisfactory assurances that their business associates are protecting the ePHI entrusted to them, and why BAAs aren’t enough. Changes being considered in federal regulations are prompting the legal counsel at many healthcare organizations to begin looking at the security policies of contractors and even subcontractors. Suddenly everyone is very interested in whether their business associates are complying with all security requirements. In this webinar we’ll cover the issues surrounding new liabilities for business-associate compliance and a continuous compliance management program you can put in place to ensure your data is protected by all downstream service providers.

With so many data breaches in the news recently across all industries, it’s important to recognize the differences between compliance, security and risk management. The relationship between these areas of your healthcare organization is critical. Security is not just about your most important systems, but also your weakest link. Having silos of information that are not cooperating or sharing with one another is a dangerous set-up. In this webinar, we’ll explain why compliance does not equal security, and why security cannot be the sole element of an effective holistic risk management program.

PAHCOM joins us to help you fill in the gaps for your small to mid-size practice. PAHCOM is the premier source of support and resources for managers and administrators of healthcare practices and will be covering the following topics:
- ICD-10 for small to mid-size practices
- How to get certified; Certified Medical Manager (CMM) and Health Information Technology Certified Manager for Physician Practice (HITCM-PP)
- EHR Incentives, Meaningful use Stage 1 & 2

EFT has hit the industry with changes to payer payment systems and introduction of the banking community to the Health care industry. This session will cover how and when EFT became a HIPAA transaction, What that really means to the industry. What the format of EFT that has been named specifically and why. How EFT is affected by Operating Rules right out the gates and the effects that NACHA has on the transaction and the industry now.

What are the ways that vendors, clearinghouses, and testing services are planning for ICD-10 testing? How do you get started? What do you need? What do the timelines say? What are some of the pros and cons of the different approaches? Listen and learn from industry experts on how their organizations are moving ahead on the path of ICD-10 testing.

This session will highlight the key challenges, especially around neutrality and partner testing, and discuss best-practices that can help healthcare organizations execute ICD-10 testing with a holistic view. Experts from healthcare organizations will share their practical experiences, approaches, and benefits and risks based on real-world ICD-10 testing programs.

On March 21, 2016, the Office for Civil Rights (OCR) initiated its long-awaited HIPAA Privacy and Security and HITECH Act Breach Notification Rule compliance audits. All covered entities and business associates not currently being investigated for a complaint or breach are subject to selection for a compliance audit. Following several initial inquiries, the desk audits are expected to begin early this summer, with electronic responses to OCR due within 10 days after date on notice of audit. This Webinar covers (a) the 2016 audit process; (b) document requirements by category of request; (c) how to use the new OCR audit protocols and how they differ from OCR’s previous audit protocols; and (d) how to achieve timely compliance.

In response to the SGR “Fix” that includes a one year delay in the implementation of ICD-10, WEDI is working to provide awareness and education to the industry. This will be a 60minute webinar to discuss how the delay affects various stakeholders, what this means for your organization and how to protect your bottom line.
Our Panelists will be sharing their personal opinions and NOT the opinions of their company/organization.

This webinar will begin with some discussion of the current status of payer/provider ICD-10 testing opportunities that may exist today. It will focus on hospital inpatient testing and will include a high-level view of the payer testing that Tampa General Hospital has enjoyed with seven different payers over the last several years. Some lessons learned will be addressed with emphasis on what to do if you haven’t been able to test with a payer. Finally the discussion will turn to internal DRG testing and some other steps that providers may take to reduce the risks that may occur with the implementation of the new code set.

The Quality Payment Program improves Medicare by helping clinicians focus on care quality and the one thing that matters most — making patients healthier. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) ended the Sustainable Growth Rate formula, which threatened clinicians participating in Medicare with potential payment cliffs for 13 years. Clinicians that participate in Medicare Part B are part of a dedicated team who serve more than 55 million of the country’s most vulnerable Americans, and the Quality Payment Program will provide new tools and resources to help them give patients the best possible care.

Payments and remittance information can be received in a variety of formats, but still need to go through the reassociation process. Payments can be received via paper check or EFT, remittance advices can be received as a paper EOB, or as an electronic 835 file. This webinar will address the reassociation process of all the formats, with an emphasis on electronic formats, and on non-zero payments. With zero payments, there is usually no check or EFT, but there will be a remittance advice that is important to receive and post. It is important to note that in order to further administrative simplification, electronic formats of both transactions are preferred whenever possible. While the primary audience for this webinar is the Provider, there is payer impact as well, which will also be included.

Unlock the value of your organization by maximizing the value of your healthcare transactions. Learn about the relationships between the EDI transaction sets. Who are the players in an EDI transaction? What is the ‘life cycle’ of a transaction? By understanding these relationships you are on your way to achieving the gold standard of reusable healthcare EDI transactions. This means less work and more value through the ability to Reuse, Reduce and Recycle healthcare EDI transactions.
Finally, understand the real value of moving your focus upstream to “managing responses” with the 270/271/276/277 transaction set.

In medical practice, physicians evaluate, diagnose and care for their patients and should be compensated for the work they do. With the upcoming changes in the healthcare environment, practitioners must become aware of the role of accurate and specific diagnostic information regarding their patients. Proper documentation and recording of these diagnoses have a myriad of benefits:
In this webinar we will discuss:
- The real purpose of good documentation of diagnostic information
- How both the diagnosis coding process and your professional billing codes are influenced by your documentation
- Current initiatives in the healthcare field and how this good documentation will have pervasive effects
- How your practice can work into this future

The intent of the the DRG Shifts tool is to provide a standard method for capturing, reviewing and discussing issues that members have identified as they have begun their analysis of the ICD-10 transition, in particular as it is related to DRGs. The intent of this product is to capture in a consistent way, those issues related to DRG shifts that may be related to:
• DRG grouper issues
• Mapping issues
• Documentation variation
• Coding variation
• Weighting changes for the same DRG.

Cherokee Health Systems (CHS) in Eastern Tennessee has been using telehealth for nearly 20 years to better serve the needs of their community. They provide a broad range of telehealth services including psychiatric care, medication counseling, consultations in public schools, and crisis care. Telehealth is not simply a program CHS uses; it is a part of how they deliver services to best meet the needs of their patients. Hear Gregg Perry, MD, Director of Psychiatric Services; Andy Rhea, MBA, Chief Information Officer; and Jeffrey Howard, CPA, Chief Financial Officer talk about the lessons learned and successes of CHS’ use of telehealth.

America’s physicians are struggling with unprecedented disruption brought on by the transition to electronic health records (EHR’s), pending changes due to the Accountable Care Act (ACA), and the emerging shift to value-based reimbursement, all of which exert growing pressures on medical practice finances. Frost & Sullivan estimates that the numerous administrative inefficiencies and redundant paperwork that physicians must deal with in order to get paid cost approximately $120 billion annually.
This webinar will address:
• How to improve the patient/physician experience and help physician practices reduce costs or even increase revenue
• The role of technology in helping small practices improve efficiency and lower costs

Recent announcements and decisions have focused a spotlight on telehealth/telemedicine. With this backdrop, Minnesota compared telehealth billing and payment laws for Medicare, for the state’s Medicaid program, and for commercial health plans. It found that recent actions have helped create both greater clarity as well as some continuing questions. It also found that due to sometimes differing regulations, not all billing and coding for telehealth is the same.

This Webinar led by Tom Winchell of Dean Health, and Brian Levy, MD, Vice President of Global Clinical Operations with Health Language, will discuss how having a set of current, approved, up-to-date terminologies, maps and value sets can help power interoperability, increase efficiency, and reduce administrative overhead for an organization.

Encounter data is the gold standard for measuring performance in healthcare. It is the feedback loop between the quality of services provided and your incentives. It measures your performance and determines risk scores. But how do you know you are accurately reporting on the services provided? Can you attest to the accuracy of your reporting? Are you maximizing the value of your encounter data? Failure to report accurately can cost your organization incentives and reimbursements.

This webinar will cover how Artificial Intelligence (AI) is changing how we deliver healthcare today. The AI will develop “Agents” that will become a digital workforce. The AI can cover large data problems that cannot easily be digested by humans to detect specific treatments, best outcomes, map genetic based treatments, eliminate error and personalize medicine. AI agents are also beginning to directly interact with individuals which will lead to new engagement paradigms, daily interactions, and collection of data elements not available with our current delivery systems.
AI will also begin interacting and providing smarter in-hospital systems through smart supply chain, reducing false alarms, and providing smart support for HAI management.
This webinar will cover these points and discuss the primary technologies utilized by the major players and the technology levels in play today.

Learning Objectives:
• Understand the benefits of remote patient monitoring in better managing chronic disease, including specific improvements to clinical outcomes and quality of care; potential cost savings and better allocation of resources; and how RPM empowers patients to self-manage their health
• The applications of connected health in discharge planning and patient transitions, including the use of a tablet to reduce exacerbations of COPD and reduce readmissions
• How virtual visits and remote consultations can connect patients from all over the world with medical specialists, provide access to care in rural areas, and deliver care to patients with mental health challenges
• How mobile technology can improve patient engagement by capturing personal health data, providing in-the-moment messaging and take advantage of the addictive nature of ‘always on’ mobile devices

Cloud computing has become a key part of how the business of healthcare is transacted today. Before looking to your cloud vendors to make sure they are compliant and have implemented sound information security it’s a good idea to take a look at your own organization first to make sure your compliance and information security program are up to snuff. Participants will learn, step-by-step, how to assess their compliance program, develop a compliance mitigation plan and follow through to build a sound program that covers the necessary ongoing compliance needs of any healthcare organization. It doesn’t matter if you represent a health plan, a health care provider or a business associate. Join the compliance discussion!

The ever-changing roadmap of legal authority for use everyday in your organization and when the “%$+%” hits the fan.
HIPAA liability and enforcement are more and more complex. It is not just OCR that will be knocking at your door or calling you when you have a privacy event or security incident. It could be the FTC or FDA. It could be a state Insurance Commissioners office. It could be a State’s Attorney General. You might have to deal with both federal law and regulations and states laws and regulations. You are sharing data in new and unique ways including through HIEs and as part of ACOs. You are being swamped with new technology every day, every week, every month. Learn what is happening in enforcement and what you can do to protect your organization now and in the future.

The process of matching up the healthcare claim payment and the remittance advice can be frustrating and challenging for Providers. Gaining a good understanding of the process needed to do this, along with recommended best practices and tools for overcoming obstacles, will allow Providers to manage the reassociation process more easily, reducing resources required for working through the process of matching the payments to the remittance, and enabling more timely posting of the information. Ensuring a good understanding of the process benefits payers as well, in reducing phone calls for research, and increasing adoption of the electronic transactions.

Speakers: Mark Goettel, Virtual Card Product Solutions, WEX Health, WEX Inc; David Gillman, CEO, NexPay
In this third and final webinar in our series on Virtual Cards, we will take a look at a use case of virtual cards in healthcare. This presentation will be a case study of a Healthcare provider using virtual cards as part of their payment mix. We will examine the payer’s goals and outcomes of their payment outsourcing in terms of payment mix, cost reduction and efficiency.

WEDI has been conducting ICD-10-CM/ICD-10-PCS (ICD-10) readiness surveys since 2009 to gauge the status of industry progress and has recently completed analysis of the August 2014 survey. These surveys are critical to assessing industry readiness and to identify stakeholders that may be struggling with compliance. This webinar will review the responses for each industry sector and offer perspectives on what the results might be telling us.

The only constant in health care is change and the same is true with health information technology (HIT). It’s the Wild West out there and the world of HIT is expanding rapidly. Between the increase in mobile device work for clinical purposes, an expansion in the use of assistive technology and new and changing patient tools to prompt greater patient participation in their own care, it can be rather daunting. It also represents a great opportunity as health care becomes more mobile. This webinar focuses on the HIT landscape today and look into the future. Along with great rewards comes greater risk. Participants will learn how to take advantage of the expanding presence of HIT in health care delivery and how to address associated risks to adoption.

The Workgroup for Electronic Data Interchange (WEDI) in partnership with the Centers for Medicare and Medicaid Services (CMS), the Cooperative Exchange and other private industry partners, has launched its ICD-10 Success Initiative webinar series. The first in a series, these webinars will help to meet the October 1 ICD-10 compliance deadline and will provide answers to common questions.
This webinar will present an overview on preparing for the Oct. 1 ICD-10 transition. Regardless of how far along organizations are in their implementation process, this webinar will cover all the bases.

The compliance date of Oct. 1, 2015 for transitioning to ICD-10 has now been confirmed by CMS. In this engaging 60-minute webinar, participants will learn about important and low-cost coding, workflow and technology action steps providers can take that will prepare for this challenging transformation while at the same time benefiting their organization in additional clinical and administrative areas. The faculty, national experts in ICD-10 implementation, will discuss critical issues including clinical documentation improvement, enhancing billing processes, improving patient transitions of care, and leveraging the move to ICD-10 to improve administrative efficiency. Following the program, participants will be armed with an action plan to effectively and efficiently move forward with ICD-10.

New to WEDI? Maybe your company has been a WEDI member for years, but it’s all Greek to you. What does WEDI do in the industry? What’s the difference between a Workgroup and a Subworkgroup? What’s a PAG? How do I get those listserv notices everyone else in my office is receiving?

This interactive webinar will help prepare attendees to assist their organization in meeting the first set of Federally mandated operating rules, Eligibility for a Health Plan and Healthcare Claim Status, that become effective January 1, 2013. Presenters will elaborate on specific operating rules and lead the audience through several CAQH CORE Operating Rule conformance testing examples.

This webinar will prepare attendees to assist their organization in meeting the first federally mandated operating rule requirements for Eligibility for a Health Plan and Health Care Claims Status transactions. This session will address the important role that both data content and infrastructure operating rules play in facilitating interoperability between health plans and providers.

Please join us for an ICD-10 State of the Union Town Hall Meeting. Hear about what took place at the WEDI Winter Forum, the new HIE effort, the ICD-10 readiness survey findings and what they mean to the industry, as well all the latest activities of the ICD-10 subworkgroups and how you can get involved.

The Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, released an ICD-10 readiness survey to determine how well the healthcare industry is progressing towards the Oct. 1, 2015 implementation deadline. 1,175 Providers, health plans, vendors and clearinghouses participated in this important initiative to help monitor progress as we move closer toward the implementation deadline. During this webinar we'll dive into the survey results so you can see where your organization stacks up.
WEDI will continue to conduct surveys throughout 2015, and information collected from these surveys will help determine where additional outreach and education is needed.

Over the past few years our healthcare delivery system has placed increased emphasis on the ability for healthcare providers to deliver the triple aim: better care, better health, and lower costs. URAC will present its perspective on recent developments in health care and its response to developing programs that promote the goals of the triple aim.
URAC, an independent, nonprofit organization, is a well-known leader in promoting healthcare quality through its accreditation, education, and measurement programs. URAC offers a wide range of quality benchmarking programs and services that model the rapid changes in the healthcare system and provide a symbol of excellence for organizations to validate their commitment to quality and accountability. Through its broad-based governance structure and an inclusive standards development process, URAC ensures that all stakeholders are represented in establishing meaningful quality measures for the entire healthcare industry.

As consumers, businesses and government agencies continue to struggle with methods to deal with online breaches of the Internet cloud’s digital security, WEDI’s new white paper, “Using PHI & Cloud Computing: A Focus on the Intersection of Cloud Technology and Privacy/Security,” highlights the current uses of the Cloud and reveals the necessary functionality to insure Protected Health Information.

There are 34 entities in the US that are classified as Health Information Exchanges (HIEs). Are some more efficient than others? Why? What are the standards for data flow in an HIE? Is an HIE dependent upon federal funding to be successful?

WEDI and the Centers for Medicare & Medicaid Services (CMS) are collaborating with ASC X12 and other industry representatives to host another online presentation in the ASC X12 5010 Implementation webinar series. The May 23, webinar addressed acknowledgements, ‘extra data’, and resolving interpretation discrepancies. Following the presentations, there will be a Q&A session.

eHealth Exchange or Health Information Exchange (HIE) is the electronic movement of health-related information among organizations according to nationally recognized standards. The goal has always been to facilitate access to and retrieval of clinical data to provide safer, timelier, efficient, effective, equitable, patient-centered care. HIEs have gone through several variations, and in this webinar we will review the past, present and future of HIEs and discuss how they can help realizing values to the providers and ultimately lead to better care.

Direct is a national encryption standard for securely exchanging clinical healthcare data via the Internet. It is also known as the Direct Project, Direct Exchange and Direct Secure Messaging. It specifies the secure, scalable and standards-based method for the exchange of Protected Health Information (PHI). It was developed in 2010 under a part of a federal project for standards-based healthcare communications and is a key component in the next stage of electronic health record implementations for many hospitals, HIEs and providers.

Long-term care and HIPAA – it seems simple on the surface. Hospitals discharge patients who need skilled rehab to nursing homes. Medicare pays. Nursing homes bill Medicare electronically and are covered entities. Simple, right? Well – not exactly. Most people in nursing homes are Medicaid residents. States run Medicaid – so there are (at least) 50 variations of what Medicaid pays for and how it gets paid. And what about the fast-growing community-based care options? Less restrictive and less expensive for patients and family – but what exactly are they where HIPAA is concerned? And what about when long-term care is part of an ACO?